Definition

Gastritis is inflammation that can occur on the surface of the stomach, either suddenly (acutely) or over an extended period (chronically). Erosive gastritis is a serious medical condition that requires urgent attention to prevent further damage to the stomach. This type of gastritis involves damage to the epithelial cells (cells on the surface), which play a crucial role in protecting the inner surface of the stomach. Ulcers can also accompany erosive gastritis.

In addition to the damage to epithelial cells, erosive gastritis also affects the mucosa layer of the stomach. This condition is a common ailment that often occurs in the elderly and is more prevalent in men than women. However, younger individuals can also experience erosive gastritis due to various causes and risk factors. The presence of erosions in the stomach can be identified through examination.

Causes

The causes of erosive gastritis are not significantly different from other types of gastritis, but the most common cause is the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are medications used to reduce inflammation, pain, and fever. Examples of NSAIDs include ibuprofen, mefenamic acid, and sodium diclofenac. These drugs are employed to alleviate pain from various conditions. Prolonged use of NSAIDs can diminish the substances that protect the stomach layer. Over an extended period, the protective layer becomes thinner and damaged, allowing stomach acid to erode the stomach lining. 

Alcohol consumption can lead to gastritis because the substances in alcohol can scrape the lining of the stomach. Excessive and continuous alcohol intake puts the stomach at risk for various digestive problems, including erosive gastritis. Stress also plays a role in the gastrointestinal system's health, especially in the production of stomach acid. The more severe the stress, the more stomach acid is produced. Overproduction of stomach acid can irritate the stomach lining, causing erosive gastritis.

In addition to the causes mentioned above, a less common factor is radiotherapy used in cancer patients, which can disturb stomach cells, making them susceptible to damage. Cytomegalovirus infection can also lead to digestive problems, including erosive gastritis. Damage to the blood vessels of the stomach can also increase the risk.

Risk factor

Some factors that can increase the risk of erosive gastritis include age and stress. Aging contributes to an elevated rate of painkiller consumption, as well as diminished function and condition of the digestive organs. Prolonged stress can worsen the digestive system. Excessive alcohol consumption is another risk factor for stomach lining erosion. Additional risks include smoking habits, a high-salt and high-fat diet, prolonged use of painkillers, autoimmune diseases like HIV/AIDS that can compromise the immune system, chronic inflammation in the gastrointestinal tract such as Crohn's disease, and parasitic infections.

Symptoms

Some patients with mild erosive gastritis may not exhibit symptoms. However, in cases where symptoms are present, individuals may experience gastrointestinal symptoms such as nausea, an urge to defecate, bloating, heartburn, upper abdominal pain, reduced appetite, and weakness.

Most of the time, the first symptom of erosive gastritis is hematemesis, which is vomiting blood that appears red or brown, resembling coffee grounds. Additionally, individuals with erosive gastritis may experience melena, characterized by black feces due to the presence of blood, or the expulsion of fluid mixed with blood in the respiratory tract and stomach, resulting from choking caused by swallowing difficulties. Symptoms of erosive gastritis can persist for 2 to 5 days. In severe cases, stomach bleeding can lead to anemia or a deficiency in red blood cells.

Diagnosis

To confirm the diagnosis of erosive gastritis, a comprehensive history-taking or anamnesis is conducted, which includes information about the symptoms, health history, and recent or discontinued drug consumption. Anamnesis is typically followed by a physical examination performed by the doctor.

Following this, to support the diagnosis, the doctor may recommend additional examinations such as a gastroscopy to detect signs of inflammation in the stomach. This procedure involves using a tube with a camera inserted into the stomach to observe its condition. Gastroscopy may also include collecting tissue samples from areas suspected of erosion or ulcers, although this is not always necessary for all cases of gastritis.

Another diagnostic tool is imaging examination through X-rays to assess the condition of the upper gastrointestinal tract. The doctor may require the patient to swallow barium before imaging to enhance visibility, especially in the stomach.

Management

Erosive gastritis can be managed with medications designed to neutralize stomach acid, such as antacids, and medications to reduce the production of stomach acid, such as ranitidine or cimetidine. If gastritis is induced by excessive consumption of anti-inflammatory drugs, the doctor may recommend discontinuing the use of those drugs. Proton pump inhibitors (PPIs) like omeprazole or lansoprazole can also be prescribed to decrease stomach acid production. PPIs effectively reduce damage to the stomach lining and aid the healing process. In severe cases involving anemia and bleeding, the doctor may establish an intravenous line and administer a blood transfusion for severe anemia.

In addition to medication, lifestyle changes can expedite the healing of erosive gastritis. Eating more frequently with smaller portions is recommended, as consuming large portions can induce stomach acid production and exacerbate symptoms. Avoiding foods that trigger symptoms, such as spicy, acidic, and fatty foods, is crucial. Ceasing alcohol consumption is also advised as alcohol can scrape the stomach lining, worsening erosive gastritis. Additionally, discontinuing excessive use of anti-inflammatory drugs is essential for managing the condition.

Complications

Prolonged gastritis can lead to complications such as chronic bleeding, resulting in severe anemia, the development of peptic ulcers in the stomach and duodenum, and abnormal growths such as tumors, malignancies, or cancer in the stomach wall.

Prevention

Disease or complications of the disease can often be managed at home. Several measures can be taken to prevent gastritis. It's advisable to consume NSAIDs according to the doctor's advice and avoid excessive use, as these drugs are known to inflame the stomach layer either acutely or chronically. Additionally, one should steer clear of raw or unclean food. Introducing yogurt or foods with probiotics into the diet can help increase the number of good bacteria in the digestive tract. Limiting alcohol consumption is important, as it can stimulate the stomach to produce more acid. Quitting smoking is recommended, as smoking contains substances that can worsen inflammation. Furthermore, improving dietary habits and effectively managing stress can contribute to prevention.

When to see a doctor? 

It is advisable to consult a doctor if there is an onset of signs or symptoms as mentioned above. Individuals may exhibit different body responses, and the severity of the symptoms correlates with the extent of damage in the stomach. Sometimes, this condition may not manifest symptoms until the damage becomes more severe. If common symptoms such as nausea or heartburn already affect the quality of life, it is recommended to visit or seek medical attention for a thorough examination and appropriate guidance.

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